兵团特殊体制下的某三甲医院医疗纠纷特征及预防  

Studying on The Characteristics and Prevention of Medical Disputes in Public Hospitals in The Special System of Xinjiang Production and Construction Corps

作　　者：宋艳鹏 郭淑霞[1] 魏斌 王丽艳[1] SONG Yan-peng(The First Affiliated Hospital,Medical College of Shihezi University,Shihezi,P.R.China)

机构地区：[1]石河子大学医学院第一附属医院

出　　处：《中国卫生事业管理》2019年第11期816-818,838,共4页Chinese Health Service Management

基　　金：新疆兵团科技攻关计划(2007GG22);石河子大学社科基金(RWSK09-Y39)

摘　　要：目的:了解新疆生产建设兵团(兵团)特殊体制下的公立医院医疗纠纷特征,为提高医疗质量,制定医疗纠纷防控措施提供参考。方法:采用描述性分析方法,选取兵团规模最大某三甲医院历年保存的349件有效医疗纠纷卷宗进行调查分析,对医疗纠纷数量、发生率、科室分布、产生原因及解决途径等情况进行分析。结果:医院年均发生医疗纠纷22件,年均赔款68.74万元;近10年来医疗纠纷呈总体下降趋势,2017年达到最低水平,每百名医务人员、每万次例手术量、每万次例业务量医疗纠纷发生数量分别为0.65件、2.40件、0.12件;骨科、心胸外科、急诊科排名居高发科室前3位;解决途径以医患双方协商为主(占83.95%);84.8%的医疗纠纷医方存在过错,49.86%的医疗纠纷产生经济赔偿;医疗纠纷医方原因一级分类前3位为治疗问题、医德医风问题、医患沟通问题,二级分类前3位分别是缺乏责任心疏忽大意、手术操作失误、并发症。结论:医疗技术水平和服务质量是导致医疗纠纷发生的主要原因。Objective To explore the characteristics of medical disputes in public hospitals under the special system of Xinjiang Production and Construction Corps, and provide references for improving medical quality and formulating prevention and control measures for medical disputes. Methods Medical records of 349 cases of medical disputes in the public hospitals of Corps were analyzed from quantity, incidence, department distribution, causes and solutions. Results The average amount of medical disputes was 22 per year, and the average annual compensation was 687,400 yuan. The amount of medical disputes in the past ten years have shown an overall downward trend, the lowest of which was in 2017. The top three departments were orthopaedics, cardiothoracic surgery and emergency department. The solution was based on consultation between doctors and patients(83.95%). There had medical faults in 84.8% of medical disputes, and economic compensation was required in 49.86% of medical disputes. The top three causes in the first-level were medical treatment, medical ethics and doctor-patient communication. And the top three causes in the second-level were lack of responsibility, surgical operation mistakes and complications. Conclusion The main factors to cause medical disputes were medical technology and quality of medical service.

关 键 词：新疆兵团 医疗纠纷 发生率 原因分析 

分 类 号：R197[医药卫生—卫生事业管理]